LIMITED ACCESS MYOCARDIAL REVASCULARIZATION - A PRELIMINARY-REPORT

A technique of limited access, direct vision surgery for performing co ronary artery bypass grafting with the internal mammary artery is pres ented in this preliminary report. The procedure is performed without c ardiopulmonary bypass. To gain access to the left (or right) coronary artery and the mammary artery segments of the 3rd and 4th costal carti lages are removed. Before the pericardium is opened, the mammary arter y is dissected distally under the 5th costal cartilage and proximally under the 3rd costal cartilage to the level of the 2nd costal cartilag e. If the left anterior descending coronary artery is suitable for byp ass, it is dissected and the bypass graft is placed. limited ac cess c oronary bypass has been completed successfully in 8 of our first 9 pat ients. Aii 9 patients have had relief of anginal pain. This experience proves that coronary bypass operations can be performed in selected l esions without a quiet bloodless field, thus avoiding the potential co mplications of cardiopulmonary bypass.